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. 2025 May 15;17(5):3766-3777.
doi: 10.62347/SHIL2671. eCollection 2025.

Safety and efficacy of rescue endovascular treatment in ischemic stroke patients with early neurological deterioration caused by large vessel occlusion

Mengmeng Chen  1 , Jun Cao  1 , Yao Li  1 , Weimin Yang  1 , Ruiqi Jia  1 , Shuiping Wang  1 , Yang Liu  2 , Jingye Wang  1
Affiliations

Safety and efficacy of rescue endovascular treatment in ischemic stroke patients with early neurological deterioration caused by large vessel occlusion

Mengmeng Chen et al. Am J Transl Res. .

Abstract

Objectives: The optimal treatment after deterioration following ischemic stroke has not been established in the current guidelines. Therefore, this study evaluated the efficacy of rescue endovascular treatment in patients with early neurological deterioration after acute ischemic stroke.

Methods: This study analyzed data retrospectively retrieved from the electronic medical records at the First Affiliated Hospital of Anhui Medical University.

Results: A total of 20 patients were included in the rescue endovascular treatment group and 23 in the medical group. The 90-day favorable outcome rate in the rescue endovascular treatment group was significantly better than that of the medical group (75.0% vs. 34.8%, P=0.031). However, no significant difference in all-cause mortality within 90 days was observed between the rescue endovascular treatment group and the medical group (5.0% vs. 8.7%, P=1.000). The 90-day prognosis of patients with mild stroke of anterior circulation and large vessel occlusion who underwent rescue endovascular treatment after deterioration was significantly better than that of those in the medical group (76.5% vs. 31.6%, P=0.010).

Conclusion: Rescue endovascular treatment is effective and safe for patients with ischemic stroke and deterioration due to large vessel occlusion, leading to no significant increase in the risk of hemorrhage or death even when the time window exceeds 24 h.

Keywords: Acute ischemic stroke; early neurological deterioration; large vessel occlusion; prognosis; rescue endovascular treatment.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Time distribution from onset to deterioration in the medical group and rescue endovascular treatment group. EVT, endovascular treatment.
Figure 3
Figure 3
Distribution of 90-day modified Rankin Scale scores in the medical group and the rescue endovascular treatment group. EVT, endovascular treatment.
See this image and copyright information in PMC

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